My Adventure with Vibrio

Summer after summer, you’d hear of some unlucky swimmer, waterman or shellfish eater. Then it happened to me

By Elisavietta Ritchie

Looking like canned green beans under a microscope, Vibrio ­vulnificus can infect open sores of swimmers in warm salty water.

On and in, I’ve swum, fished, crabbed, eeled, sailed, canoed, kayaked and written about the Patuxent River — from both sides — since 1960. When you live with a place for over 60 years, you think you know it.
From the birds that harvest the river … the migratory swans, geese, red-winged blackbirds and songbirds that visit … myriad sea creatures, terrapins, wiggly critters in the muck, ghosts of Patuxent Indians and later lost sailors who all sleep beneath — I love my river.
Microscopic bacteria, Vibrio vulnificus, aptly nicknamed the terror of the seas, also lurk in the river. Suddenly they tried to do me in.
In warm coastal waters, including our Bay and the Gulf Coast states, Vibrio infect swimmers who venture in with open sores. Summer after summer, you’d hear about how the bacteria got some unlucky swimmer, waterman or shellfish eater. A few victims die from cellulitis and sepsis. In 2009, the Chesapeake Bay Foundation noted Vibrio’s increased incidence coincident with warmer waters and nutrient pollution.
This summer, it happened to me.
I was one of 16 Maryland victims of the flesh-eating bacteria tallied by the end of July 2014. Five of us got it in Calvert County.

How It Happened to Me
The bacteria struck on my June 29 birthday. That afternoon, my doctor daughter and I had a fine kayak paddle downriver, setting out against wind and tide. Back at our splintery dock, jeans and all, I jumped into the briny waters.
Scrambling up our makeshift ladder, I scraped my shins. Cuts are nothing new for me, everyday reminders of vulnerability. Before I had a chance to shower, I hung around in river-wet jeans, granting sufficient points-of entry to Vibrio vulnificus.
Twenty-four hours later, increasing swelling and purpling in my left leg frightened my spouse, a medic on the front lines of the Korean War. “We’re heading to the ER right away!”
“Nonsense! I’ll be fine!”
But my bruised leg continued swelling, my foot looked as if stuck in a rosy baseball mitt, so to placate him, I acquiesced.
We reached Calvert Hospital’s Emergency Center at 8pm. Seems I’d already borne several superficial sores as well as new ones acquired scrambling up the ladder.
Midnight an orderly wheeled me to a hospital room for a week of being jabbed with sharp instruments by otherwise-nice nurses inserting IVs for a half-dozen diverse antibiotics pumped into my veins.
My children gathered with long faces asked about my “final directives.”
“A grand party,” I answered, “down by the riverside!”
To learn about the beast, I searched Wikipedia. In its magnified photo, the bacteria resemble canned green beans on hospital trays.
After discharge, we made regular return visits to the wound center. At home, I’m supposed to remain a lady of leisure, my slowly healing left leg propped higher than my head. My progeny wait on me. Not my normal lifestyle. But if I walk too much, as today, the ankle swells and turns rosy.

CDC on Vibrio

Vibrio vulnificus is a bacterium in the same family as those that cause cholera and Vibrio parahaemolyticus. It normally lives in warm seawater and is part of a group of vibrios that are called halophilic because they require salt.
Vibrio vulnificus can cause disease in those who eat contaminated seafood or have an open wound that is exposed to seawater. There is no evidence for person-to-person transmission of V. vulnificus.
Among healthy people, ingestion of Vibrio can cause vomiting, diarrhea and abdominal pain.
In immuno-compromised persons, particularly those with chronic liver disease, Vibrio can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock), and blistering skin lesions. Vibrio bloodstream infections are fatal about 50 percent of the time.
Doctors should have a high suspicion for this organism when patients present with gastrointestinal illness, fever or shock following the ingestion of raw seafood, especially oysters, or with a wound infection after exposure to seawater.
If Vibrio is suspected, treatment should be initiated immediately because antibiotics improve survival. Aggressive attention should be given to the wound site; amputation of the infected limb is sometimes necessary.
Those who recover should not expect any long-term consequences.
An average of 50 culture-confirmed cases, 45 hospitalizations and 16 deaths are reported each year from the Gulf Coast region (reporting states are Alabama, Florida, Louisiana, Mississippi, and Texas). Nationwide, there are as many as 95 cases (half of which are culture confirmed), 85 hospitalizations and 35 deaths.